Category Archives: Collegiate Sports

Posted on by oakwoodsportsmedicine

headsup

A concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. Even a “ding,” “getting your bell rung,” or what seems to be mild bump or blow to the head can be serious. ( www.cdc.gov/concussion/sports )

An estimated 1.6 – 3.8 million individuals are affected each year by concussions. That’s a staggering number and indicates the need for diligence and appropriate follow up care.

Last week the American Academy of Neurology issued their updated guidelines on sports concussion. This is a big deal – neurologists are involved in the evaluation & management of traumatic brain injuries and the AAN is their representative professional organization - so having them (AAN) issue updated guidelines speaks to the amount of attention this topic has received. And deservedly so. AAN’s most recent update on sports concussions came in 1997. The AAN guidelines are based on a review of all available research through June 2012.

More interesting is that a majority of healthcare providers and state-level organizations have already made changes and have been following these “new” guidelines for a couple of years now.

So What’s “New”?

  • Move away from grading classifications – concussion severity and return-to-play decisions used to be determined based on a grading scale. No more. AAN states, “concussion and return to play be assessed in each athlete individually.”

 

  • Among the most important recommendations the Academy is making is that any athlete suspected of experiencing a concussion immediately be removed from play and;

 

  • Not returned until assessed by a licensed health care professional trained in concussion, and;

 

  • Return to play slowly and only after all acute symptoms are gone.

 

  • Athletes of high school age and younger should be managed more conservatively in regard to return-to-play, as they take longer to recover than college athletes.

 

  • The first 10 days following a concussion appears to be the period of greatest risk for being diagnosed with another concussion.

 

  • Among the sports in the studies evaluated, risk of concussion is greatest in football and rugby, followed by hockey and soccer. The risk of concussion for young women and girls is greatest in soccer and basketball.

 

  • An athlete who has a history of one or more concussions is at greater risk for being diagnosed with another concussion.

 

  • The first 10 days after a concussion appears to be the period of greatest risk for being diagnosed with another concussion.

 

  • There is no clear evidence that one type of football helmet can better protect against concussion over another kind of helmet. Helmets should fit properly and be well maintained.

 

  • Licensed health professionals trained in treating concussion should look for ongoing symptoms (especially headache and fogginess), history of concussions and younger age in the athlete. Each of these factors has been linked to a longer recovery after a concussion.

 

  • Risk factors linked to chronic neurobehavioral impairment in professional athletes include prior concussion, longer exposure to the sport and having the ApoE4 gene.

 

  • Concussion is a clinical diagnosis. Symptom checklists, the Standardized Assessment of Concussion (SAC), neuropsychological testing (paper-and-pencil and computerized) and the Balance Error Scoring System may be helpful tools in diagnosing and managing concussions but should not be used alone for making a diagnosis.

 These guidelines are not necessarily new, however, having the recommendations all under one document will serve a greater purpose, that is the health and safety of young people involved in athletics. Oakwood Sports Medicine is pleased to see the evidence-based review that took place, resulting in the updated guidelines from a professional organization such as the American Academy of Neurology.

What A Difference A Year Makes

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What a Difference a Year Makes

About this time last year I wrote a post about working with the Wayne County Community College District Basketball Teams. Teams which practiced and played in an old yellowed tinted gym with limited players and funds.

What a difference a year makes, as of January 17, 2013 the men’s team is 9-5 overall and 4-1 in the league with a tough loss to Mott CC. The women’s team, which struggled even fielding enough players last year is 2-3 in the league and is also playing really well.

The teams have moved to a brand new facility with all the bells and whistles. With all the new amenities the number of fans has also increased dramatically. When previously you could only hear the hum of the lights and crickets, now it is hard to hear yourself think. Personally as the athletic trainer I went from having a small area next to the bleachers to a room filled with supplies.

The changes to the program have come from the dedication of the coaches who double as the Athletic Directors and support staff. They have truly grown the program in right way. From last year to this I have seen multiple students who were previously ineligible for whatever reason work hard to get back to playing the sport they love.

Ryan Rodd, ATC is a member of the Oakwood Sports Medicine staff. Ryan provides medical services to Dearborn Fordson High School and WCCCD.

Supplements In Athletics: Energy Drinks & Performance

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Update: 

A study released last week by the federal government, suggests the number of emergency room visits (over a 4-year period) seeking treatment after ingesting energy drinks doubled from 10,000 to more than 20,000. Most of these cases involved teenagers or young adults. In 2011, over 40% of  cases involved energy drinks taken in combination with alcohol or prescription medicines Adderal and Ritalin (stimulants).

Read more about the study here.

The use of supplements, plants and derivatives, foods and over-the-counter medicines has been documented in competitive athletics for many years, typically in the high school level and above.

As related in a previous post, we discussed the need for parents, coaches, athletic trainers and other health professionals to be educated on what products athletes are asking for or interested in – try to stay ahead of the curve by reading the popular fitness magazine or checking out the local “health food” stores.

What has become apparent in just the recent past couple of years, is a general increase in the use of energy drinks by a much younger age group, such as middle school kids. The companies that make and sell these products (Monster, Full Throttle, Red Bull, for example) are using marketing plans (sponsoring concerts, races, droid apps, selling merch and swag) to attract a younger more youthful group of consumer – tobacco companies made this tactic very successful.

Beverage Digest reported a sales increase of 17% to $9 billion dollars last year of highly caffeinated soft drinks. This week, the two ounce shot, 5-Hour Energy, has been mentioned in some 90 FDA filings since 2009, including more than 30 that involved serious or life-threatening events like heart attacks, convulsions, and in one case, a spontaneous abortion, the New York Times reported.

Whether or not the increased consumption by younger people is specifically for the purposes of performance enhancement makes no difference. The fact that kids are consuming energy drinks period should be of concern to parents.

Why?

1. Because energy drinks fall into the FDA’s category of supplements – which means the product is held to a less-constraining set of standards for ingredients, creating and content. Companies are not required to disclose the amount of any indgredient, although they are very quick to point out the high levels of vitamins contained in their products!

2. High level athletes are subject to drug testing which means they must be very cautious about their dietary consumption, especially unknown ingredients.

3.  A few ingredients in supplements may present safety issues for some segments of the population because of special age or health considerations. Consumers of energy drinks may be at higher risk for health problems such as caffeine toxicity, nervousness, cardiac arrhythmia, seizures or even death.

For more information on dietary supplements, the content in these links has proven to be reliable and of sound science.

Sports, Cardiovascular, and Wellness Nutrition (SCAN)

Eating For Exercising and Sports

Academy of Nutrition and Dietetics

 

ACL Injuries on Champions of Care

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Professional athletes have to worry about offense, defense … and protecting their knees. In nearly every sport, tearing the anterior cruciate ligament, or ACL, is a daily danger—and can end careers. Today we’re talking to Dr. Marc Milia, an Oakwood-affiliated orthopedic surgeon about why this can happen, and what treatments can get you back on the field.

To listen to Dr Milia talk about ACL injuries, click here.

 

 

Concussion Legislation Update: Michigan Joins In

Posted on by oakwoodsportsmedicine

 

Governor Rick Snyder signed youth concussion legislation into law yesterday. The aim or intent of Public Act 342 and 343  is to increase awareness, educate sport coaches and mandate physician clearance prior to returning to sport following a concussion. The legislation pieces were introduced simultaneously by Senator John Proos and Representative Tom Hooker.

As previously posted Oakwood Healthcare, the Detroit Lions, Wayne State University, MHSAA, BIAMI and Michigan Athletic Trainers Society supported the legislation. Numerous healthcare professionals, physicians, athletic trainers and school administrators were also active in supporting this important legislation.

We need legislation for this why?    ~ Reader Comment Posted here

Education and awareness efforts are the cornerstone building blocks for bringing about a change within a designated group, organization or population. A beautiful example of education/awareness exists in the area of early screening and detection methods for several forms of cancer.

Let’s not be naive – public forums are a place for “the people” to express their opinions. There were several hundred comments on a different online article about the Michigan legislation while it was being read in the House. The majority of those comments were anti-Snyder, politically based viewpoints.

And yes, a change is necessary within the athletic community regarding  concussions in athletics.

Even as recently as this football season, a high school level coach was told by an athlete about concussion-like symptoms and that coach encouraged and allowed the athlete to return to the game. Really?

While no method of intervention is fail-safe (except taxes and death), lack of action is unacceptable when it comes to concussions in athletics. The  latest legislation is a building block towards providing a safer environment for youth participation in athletics.

 

 

 

Lions Coach Gets It Right: There’s Nothing Simple About Concussions

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(Photo courtesy of the the Detroit Free Press)

Detroit Lions running back Jahvid Best has been on the physically unable to perform list with a concussion. Earlier this week Best underwent a series of tests to reassess his condition and progress. Okay, so what’s the importance?

First of all, with concussions in the news nearly every day now, the potential return of a professional athlete to their sport following a concussion is a big deal. Lots of attention, lots of second guessing.

The one firm, solid and spot on point regarding Best isn’t about when or if he will return to the active roster soon. It’s how Lions head coach Jim Schwartz described concussions today in the Detroit News.

 

“That’s one thing we all know about concussions — there’s nothing simple about them. It’s not like any other injury. It’s not just a red light or green light; there are a lot of shades in there. We’ll just defer to the people who know the most and wait just like everybody else.”
 
 
Exactly. There’s nothing simple about concussion. Every person is different and so is every concussion. Concussions are a complex brain injury – nothing mild or simple about the injury or recovery.
Thank you Coach Schwartz for handling your statement in a very accurate and truthful manner.

Preventing Heat Illness In Athletics

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“An ounce of prevention is worth a pound of cure.”

~ Benjamin Franklin

The prevention of heat illness in athletics is in the best interest of everyone involved. It takes a culture of education, understanding and proactive decision-making by coaches, athletes, parents, schools and athletic trainers in order for this to happen.

With the beginning of fall sports in early August, the combination of high temperatures and humidity is certain to create problems for athletes and athletic trainers must keep a watchful eye on them. The National Center for Catastrophic Sports Injury Research in their 2011 report, indicates there were a total of 5 deaths due to heat stroke (all at the high school level). Since 1960, there have been 132 deaths attributed to heat stroke. For a brief look at heat illnesses we previously posted, read this. The NCCSI also maintains that deaths from heat illness are unnecessary as they are preventable.
 

Here’s a look at proactive measures to prevent heat illnesses at your school or organization:

  1. An athlete must have a completed physical examination by a physician prior to beginning any type of participation in sports. This is recommended by many appropriate organizations (NCCSI, NATA, ACSM, NFHCA) and required by the MHSAA.
     
  2. Ensure that all sports and coaches follow weather related recommendations for participating in the heat and humidity, including the mandated acclimatization periods before full equipment is worn.
     
  3. Monitor weather conditions frequently (temperature, humidity, WBGT) and activate processes for curtailing sessions when required. This includes ending or cancelling sessions due to WBGT readings.
     
  4. Be an advocate for changing existing rules to encourage rest and recovery, especially those regarding two-a-days, lengthy sessions (greater than 3 hours at a time) and limit consecutive dates of sessions to 6 or less.
     
  5. Have all athletes weigh-in before and after each practice session. Loss of more than 4% to 5% of the recorded pre-practice bodyweight must be replenished prior to participation in the next practice session.
     
  6. Ensure that plenty of cold water is readily available for practices & competition. Research has shown that competitors are likely to take in more water when its temperature is cooler (55 – 57 degrees). Encourage the use of sports drinks after practice and during the overnight period to replenish fluids.
     
  7. Athletes must have freedom to access fluids during sessions – this may mean water bottles placed at each drill, or the ability to get a drink at any time.  Freedom to access means the coaches must also encourage, not discourage athletes to drink fluids and enhance the culture by not punishing, belittling or chastising athletes for asking for fluids. Build into the schedule a 10 – 15 minute water break every 25-30 minutes during hot weather.
     
  8. The ability and knowledge of the athletic trainer should be such that  immediate decisions and actions are taken to remove an athlete’s gear, move them into an air conditioned environment or possibly more aggressive measures to prevent the progression of heat illness.

WSU Baseball Qualifies for NCAA Regional

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(Courtesy of Wayne State University ~ Athletics)

Wayne State Baseball earned a berth in the NCAA Midwest Regional tournament, their third consecutive appearance and fifth since 2005.

The Midwest Regional will be held on the campus of Eastern Michigan University. WSU is the host institution for the event. The Warriors will take on Northern Kentucky on Thursday.

Go Warriors!

Above All Else…It’s About Player Safety

Posted on by oakwoodsportsmedicine

This past weekend during the Michigan Amateur Hockey Association regional championships, it has been widely reported that a  wave of norovirus affected an exactly unknown number of hockey players from more than one team during the tournament. Several players were vomiting prior to taking the ice for their game, some were sick on their team bench and some players were not dressed for the game.

The Victory Honda U-18 Midget Major team was down several players due to “flu-like” symptoms even before the game started. Victory Honda lost in overtime to the Little Caesars team. With the loss, Victory Honda goes home and Little Caesars advances for a chance to win a national championship in April.

The discussion today on the “Karch & Anderson” Show on WDFN focused on whether it would be fair to the winners (Little Caesars) to have to replay the game and that there was a greater life lesson here. For the record, MAHA has said publicly that the game would not be replayed – Victory Honda appealed that decision with MAHA and to USA Hockey, hoping for another shot at “fairness” for their players. Nothing wrong with standing up for your players, right?

“One’s been sick all night,” John Stansik, director for the Victory Honda AAA hockey club, said today. “I’m not worried about hockey — I’m worried about the boys.”

The most disturbing comment to come out, from a pure health perspective, is attributed to another Victory Honda coach, Bill Smith:

“We didn’t think there was anything wrong; we thought a flu was going through,” he said, adding that two other players continued to play while vomiting on the bench. “That’s the rub of it – nobody’s going to refuse to play. We finished our game, even though we were missing six, seven kids.

The point of this blog post is not about the teams wanting a second chance to move on in the playoffs, nor with any specific coach or official on any team. It’s about player safety – above all else.

Norovirus is mistakenly identified as “stomach flu”, when in fact is not at all related to influenza. Symptoms usually include nausea, vomiting, diarrhea, and stomach cramping. Sometimes people have a low-grade fever, chills, headache, muscle aches, and a general sense of tiredness. The illness is usually brief, with symptoms lasting only 1 or 2 days.

THESE SYMPTOMS ARE INCOMPATIBLE WITH PARTICIPATING IN ATHLETICS!!

Kudos to the parents of the players that  didn’t  dress for the game because they were ill.

And it would be easy to place an enormous amount of blame on the coaches for allowing players to even play in a game when ill – however, these are high school aged young men and they would play no matter what and yes, sometimes they will hide or lie about an illness in order to participate.

However…..once these players became ill on the bench, during the game, the responsible adult on that team’s bench should have immediately removed said player(s) from the bench, if for nothing else, the safety of all the players. There is nothing normal about an athlete vomiting during competition.

Norovirus is spread through contact with body fluids (vomit, stools) and can be easily spread by contact with a surface that is contaminated with the virus – water bottles, towels, equipment, hand contact.

If any of these players were carrying the norovirus before the weekend, it was quickly spread to their team mates, other teams and even the families of players – norovirus is highly contagious.

Oakwood Sports Medicine has no vested interest in any of the teams that played in the tournament and we certainly have no agenda against the teams, coaches or officials. Our pure intent is to highlight the absolute necessity of having qualified healthcare professionals (athletic trainers) affiliated with a team or organization – above all else, it’s about player safety.

#NATM